Hepatocellular carcinoma (HCC) is the most common form of liver cancer in adults, accounting for approximately three of every four cancers in the liver (El-Sarag et al. 1999, New England Journal of Medicine 340: 745-750). The American Cancer Society estimates that more than 24,000 new cases of primary liver cancer develop each year in the United States, of which approximately 19,000 result in death. HCC is common in developing countries, particularly in sub-Saharan Africa and Southeast Asia (Trevisani et al. 2008 Carcinogenesis 29: 1299-1305; and O'Brien 2004 Cancer Journal 10: 67-73).
More than 500,000 people are diagnosed with HCC each year worldwide (Trevisani et al. 2008 Carcinogenesis 29: 1299-1305; and Bruix et al. 2006 Oncogene 25: 3848-3856). HCC is difficult to diagnose in its earliest stages because there are currently no screening tests available, and HCC generally becomes symptomatic when the tumor is approximately 4.5 centimeters to eight centimeters in diameter (Trevisani et al. 2008 Carcinogenesis 29: 1299-1305; and Colombo 1992 Hepatol 15: 225-236).
Detection by ultrasound and imaging by computed tomography (CT) scans or magnetic resonance imaging (MRI) lack ability to definitively and reproducibly diagnose early stage cancers, particularly small HCC tumors (Bruix et al. 2006 Oncogene 25: 3848-3856; Hain et al. 2004 Cancer Journal 10: 121-127; Okuda 2000 J. Hepatol 32: 225-237; and Sheu et al. 1985 S. Cancer 56: 660-666). Misdiagnosis of HCC yielding false positive or false negative results is common from these imaging techniques, and the American Cancer Society estimates that HCC patients have a five-year survival rate of just 10%.
New techniques for imaging and early diagnosis of HCC and other cancers are needed to improve prognosis of cancers such as HCC.